Abstracts

Summary: Every day about 500 people develop epilepsy as a consequence of traumatic brain injury (TBI), and 60-80% of these patients have seizures that are refractory to treatment. Up to 45% of patients with severe TBI develop epilepsy, suggesting that this patient population would be an ideal group for the testing of antiepileptogenesis treatments. However, given the risks inherent in testing drug treatments in asymptomatic patients, a major challenge is how to select those subjects with the highest likelihood of epilepsy for this early preventive treatment. Recently, new biomarkers have been identified that predict the likelihood of developing epilepsy after status epilepticus, which suggests that the opportunity to identify at-risk TBI patients may soon be a reality. Unfortunately, we currently do not have promising drugs that are effective for the prevention of epileptogenesis, nor do we have an accepted strategy for preventive treatment. During this session, Dr. Lowenstein will discuss the current situation concerning the treatment of patients with initial brain injury such as TBI, encephalitis and stroke; Dr. Jensen will review emerging information about basic mechanisms and molecular signaling cascades involved in epileptogenesis and their potential as targetable intervention points; and Dr. Karsten will present data related to the prediction of epileptogenesis after brain injury on the basis of analysis of peripheral blood samples. The discussion will focus on the practical steps that should be taken to implement earlier preventive treatment in the clinic.